The Mental Capacity Act (2005) (MCA) is part of the legislative framework of the NHS. Small scale studies in a range of health settings have shown that the understanding and use of the MCA (2005) varies considerably in different services and across staff of differing occupations and grades. The experiences of individual staff in using the MCA has received little attention. This grounded theory study aimed to explain how staff working with people with a learning disability (PWLD) make sense of and use the MCA, whilst also exploring the factors that influence applying the MCA in clinical practice. This study involved 11 healthcare staff from a specialist learning disability service that had used the MCA in the six months prior to their participation in the research. Staff interviews provided narratives about how they had used the MCA. A theoretical framework was developed from the analysis which underpinned three core conceptual categories. The first core category was that of ‘professional risk’ in which staff have awareness of a series of risks that pertain to themselves or the service user that could have negative professional or legal consequences. The second core category described ‘emotional risk’, which affected both the staff and service user. Staff appeared to experience those risks as feelings in the form of anxiety or concern. Both ‘professional risk’ and ‘emotional risk’ bring about ‘strategies’ which mediate the risk; allowing staff to justify and document their position, creating what feels like safe practice for both the staff and service user. Factors which facilitate the use of the Act are concerned not only with these risks but the significance of the decision that the service user has to make. The findings suggest that there is much uncertainty in the process of using the Act, some of which is due to the subjective nature of evidence gathering. The study suggests that peer support offers a range of factors important to education and development of experience in using the Act, along with helping staff cope with the outcome of decision making. The findings have clinical implications for those involved in managing difficult assessments and decision making, including how to gain an appropriate balance between risk and human rights against a backdrop of adversity that can be present for people with a learning disability. Further implications clinically and for future research, along with limitations of the study are also discussed.
| Identifer | oai:union.ndltd.org:bl.uk/oai:ethos.bl.uk:579377 |
| Date | January 2013 |
| Creators | McVey, Julie |
| Contributors | Golding, Laura; Williams, Jim |
| Publisher | University of Liverpool |
| Source Sets | Ethos UK |
| Detected Language | English |
| Type | Electronic Thesis or Dissertation |
| Source | http://livrepository.liverpool.ac.uk/10673/ |
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